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Cited by 10Obesity, Physical Activity, DietObesity and Health PracticesHealth disparities and outcomes

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Effectiveness of a socially adapted intervention in reducing social inequalities in adolescence weight. The PRALIMAP-INÈS school-based mixed trial

and the PRALIMAP-INÈS trial group, Briançon, Serge, Legrand, Karine, Muller, Laurent, Langlois, Johanne, Saez, Laura, Spitz, Elisabeth, Quinet, Marie-Hélène, Böhme, Philip, Lecomte, Edith, Omorou, Abdou Y.·2020·International Journal of Obesity
DOI 10.1038/s41366-020-0520-z
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Abstract

Background A high prevalence of overweight/obesity among low socioeconomic status adolescents contributes to health inequalities. However, evidence-based interventions for reducing social inequalities in adolescent weight are lacking. We aimed to investigate whether strengthened care management for adolescents with low socioeconomic status has an equivalent effect in reducing overweight as standard care management in adolescents with high status. Methods PRALIMAP-INÈS was a multicentre trial including 35 state-run high and middle schools in the north-eastern France. A population-based sample of 1639 adolescents aged 13-18 years with screened and clinically confirmed overweight/obesity were proposed for inclusion and divided into two groups by the Family Affluence Scale score: advantaged (score > 5), receiving standard care management (A.S) and less-advantaged randomly assigned to two groups (1:2 ratio): standard care management (LA.S) and standard and strengthened care management (LA.S.S). Interventions were based on the proportionate universalism principle: universal standard care for all groups and proportionate care for the LA.S.S group. Main outcome was body mass index z-score (BMIz) assessed before and 1 year after inclusion. Results A total of 1419 adolescents were included and 1143 followed up at 1 year: 649 in A.S, 158 in LA.S and 336 in LA.S.S groups. BMIz decreased significantly for boys (-0.11 [95% CI, -0.13 to -0.08]; p < 0.0001) and girls (-0.05 [-0.08 to -0.03]; p < 0.0001). No equivalence between LA.S.S and A.S groups was evidenced. For girls, the trend to superiority for LA.S.S was confirmed by the more favourable change (-0.06 [-0.11 to -0.01]; p = 0.01) observed on superiority analysis, with no differential change for boys (0.02 [-0.03 to 0.08]; p = 0.41). Conclusions A public health school-based intervention using the proportionate universalism principle may be effective in not worsening or even reducing overweight social inequalities in adolescents, especially for girls. Overcoming social barriers may help health professionals dealing with the burden and inequalities of overweight in adolescents.

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Metadata

Authors
and the PRALIMAP-INÈS trial group, Briançon, S., Legrand, K., Muller, L., Langlois, J., Saez, L., Spitz, E., Quinet, M.-H., Böhme, P., Lecomte, E., & Omorou, A. Y.
Affiliations
  • Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est (FR)
  • Inserm (FR)
  • Conservatoire National des Arts et Métiers (FR)
  • Centre Hospitalier Régional et Universitaire de Nancy (FR)
Corresponding author
Briançon, Serge
ORCID
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2020-01-22
Volume
44
Issue
4
Pages
895-907
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/s41366-020-0520-z
OpenAlex
W3001520467
Cited by
10
References
45
Citations by year
2025: 2 · 2024: 3 · 2023: 2 · 2021: 1 · 2020: 2
FWCI
0.94
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
  • Social Sciences › Health › Health disparities and outcomes
Keywords
adolescent overweight, adolescent obesity, health disparities, socioeconomic status, proportionate universalism, care management, school-based intervention, public health interventions, BMI z-score, girls
MeSH terms
Adolescent, Body Weight, Female, France, Humans, Male, Prospective Studies, Socioeconomic Factors, Body Mass Index, Overweight, Pediatric Obesity

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and the PRALIMAP-INÈS trial group, Briançon, S., Legrand, K., Muller, L., Langlois, J., Saez, L., Spitz, E., Quinet, M.-H., Böhme, P., Lecomte, E., & Omorou, A. Y. (2020). Effectiveness of a socially adapted intervention in reducing social inequalities in adolescence weight. The PRALIMAP-INÈS school-based mixed trial. International Journal of Obesity. https://doi.org/10.1038/s41366-020-0520-z